While the opioid crisis is wreaking havoc in Western Canada, Quebec is also experiencing an increase in drug overdoses.

According to data from the Quebec institute of public health (INSPQ), more than 500 people died of suspected opioid or other drug intoxication between October 2021 and September 2022.

While 90 per cent of the approximately 32,000 Canadian opioid-related deaths have occurred in British Columbia, Alberta and Ontario, unprecedented rates have also been observed in the Quebec City and Montreal regions since 2016.

"The first wave of street fentanyl was in Montreal in the summer of 2014. By chance, a batch of bad fentanyl ended up on the street, and there were several overdoses in those two weeks... But the crisis we are currently experiencing started at the beginning of the pandemic," said Christopher Kucyk, a trainer and support officer at PROFAN 2.0, which offers training on overdose prevention.

According to data from the Quebec Coroner's Office (BCQ), regions across the province experienced a total of 1,258 overdose-related deaths from January 2019 to July 2022. The majority of these were men aged 40 to 59.

"It's not the drug that makes people die; it's the stigma," said Kucyk. "People are hiding to use, they are alone, and so there is no one to intervene with them."

In the first year of the pandemic, the BCQ recorded an increase of about 25 per cent in deaths possibly or probably related to drug intoxication compared to the previous year.

Data from the director of Montreal regional public health (DRSP) show that emergency interventions in supervised injection services (SIS) are four times more frequent than in 2019-2020. Distribution of naloxone -- a drug that temporarily reverses the effects of an opioid overdose -- by community agencies also increased by at least 63 per cent in Montreal between the pre-pandemic year and last year.

Some addiction services have nevertheless improved in recent years, such as supervised injection services (SIS). In Montreal, there are three fixed sites and a mobile unit that allow injection drug users to dose safely.

Despite this, the current crisis requires an improvement in the services offered to the population, as they are still insufficient, according to Dominique Gagné-Giguère, a worker for the Montreal organisation Méta d'Âme.

"Even though there was a statistical lull in 2021 for fatal overdoses, it was almost the worst year for non-fatal accidental overdoses. 2022 is shaping up to be the second worst year for fatal overdoses in Quebec," he said. "The situation clearly calls for either increased funding or government initiatives that have concrete impacts, but that's not what we're seeing."


"In Quebec, more than one person a day dies from a drug overdose, and even then, we're talking about recorded deaths," said Kucyk, an injection drug user himself.

In 2021, more Quebecers died from an overdose than in a car accident. However, the problem is still relatively little discussed in the media.

"It's not stigmatizing to warm up a car, but it's very stigmatizing to inject or to use drugs at all," said Gagné-Giguère. "The public is aware that there is a crisis, but it affects such a vulnerable and stigmatized population that, in the end, it doesn't occupy much space in the public discourse."

While fentanyl has been associated with the rise in overdoses for some time, new psychoactive substances are increasingly circulating on the Quebec black market. This is the case with carfentanil, which is considered 4,000 times more potent than heroin and 100 times more potent than fentanyl.

"What has been exacerbated by the pandemic is that imports of foreign substances have stopped. People turned to local stock made with dubious mixtures, and it was really more complicated to know what was being consumed," said Gagné-Giguère, adding that substance analysis is not yet a very established practice.

A lot of awareness-raising work remains to be done to tackle this problem, he said, particularly with the police. Although more and more patrol officers are carrying a naloxone kit, many of them do not have the appropriate training to intervene with users in crisis.

"The overdose crisis, unfortunately, is far from over. Until the authorities act in a way that is commensurate with what we see on the streets, fentanyl is here to stay," said Kucyk.

This report by The Canadian Press was first published in French on Jan. 8, 2023.